7.9 Health in Early Childhood

While preschoolers are becoming more and more independent, they depend on their caregivers to keep protecting and promoting their health.²⁷⁹

7.9.1 Childhood Obesity

Childhood obesity is a complex health issue. It occurs when a child is well above the normal or healthy weight for his or her age and height. Childhood obesity is a serious problem in the United States putting children at risk for poor health. In 2015-2016, 13.9% of 2- to 5-year-olds were obese.

Where people live can affect their ability to make healthy choices. Obesity disproportionally affects children from low-income families.

7.9.1.1 Causes of Obesity

The causes of excess weight gain in young people are similar to those in adults, including factors such as a person’s behavior and genetics. Behaviors that influence excess weight gain include:

• eating high calorie, low-nutrient foods

• not getting enough physical exercise

• sedentary activities (such as watching television or other screen devices)

• medication use

• sleep routines

Figure 7.9: A child watching TV instead of playing.²⁸⁰

7.9.1.2 Consequences of Obesity

The consequences of childhood obesity are both immediate and long term. It can affect physical as well as social and emotional well-being.

• More Immediate Health Risks

  • High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD).

  • Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes.

  • Breathing problems, such as asthma and sleep apnea.

  • Joint problems and musculoskeletal discomfort.

  • Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).

• Childhood obesity is also related to

  • Psychological problems such as anxiety and depression.

  • Low self-esteem and lower self-reported quality of life.

  • Social problems such as bullying and stigma.

• Future Health Risks

  • Children who have obesity are more likely to become adults with obesity.11 Adult obesity is associated with increased risk of a number of serious health conditions including heart disease, type 2 diabetes, and cancer.

  • If children have obesity, their obesity and disease risk factors in adulthood are likely to be more severe.²⁸¹

7.9.2 Food Allergies

A food allergy occurs when the body has a specific and reproducible immune response to certain foods. The body’s immune response can be severe and life threatening, such as anaphylaxis. Although the immune system normally protects people from germs, in people with food allergies, the immune system mistakenly responds to food as if it were harmful.

Eight foods or food groups account for 90% of serious allergic reactions in the United States: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts.

The symptoms and severity of allergic reactions to food can be different between individuals, and can also be different for one person over time. Anaphylaxis is a sudden and severe allergic reaction that may cause death.4Not all allergic reactions will develop into anaphylaxis.

• Children with food allergies are two to four times more likely to have asthma or other allergic conditions than those without food allergies.

• The prevalence of food allergies among children increased 18% during 1997-2007, and allergic reactions to foods have become the most common cause of anaphylaxis in community health settings.

• Although difficult to measure, research suggests that approximately 4% of children and adolescents are affected by food allergies.

The CDC recommends that as part of maintaining a healthy and safe environment for children, caregivers should:

• Be aware of any food allergies.

• Educate other children and all adults that care for a child with food allergies.

• Ensure the daily management of food allergies.

• Prepare for food allergy emergencies.²⁸²

7.9.3 Oral Health

Tooth decay (cavities) is one of the most common chronic conditions of childhood in the United States. Untreated tooth decay can cause pain and infections that may lead to problems with eating, speaking, playing, and learning. The good news is that tooth decay is preventable. Fluoride varnish, a high concentration fluoride coating that is painted on teeth, can prevent about one-third (33%) of decay in the primary (baby) teeth. Children living in communities with fluoridated tap water have fewer decayed teeth than children who live in areas where their tap water is not fluoridated. Similarly, children who brush daily with fluoride toothpaste will have less tooth decay.

Applying dental sealants to the chewing surfaces of the back teeth is another way to prevent tooth decay. Studies in children show that sealants reduce decay in the permanent molars by 81% for 2 years after they are placed on the tooth and continue to be effective for 4 years after placement.²⁸³

The first visit to the dentist should happen after the first tooth erupts. After that, children should be seeing the dentist every six months.²⁸⁴

Figure 7.10: A dentist checking a child’s teeth.²⁸⁵

7.9.4 Protection from Illness

Two important ways to help protect children from illness are immunization and handwashing.

7.9.4.1 Immunizations

While vaccines begin in infancy, it is important for children to receive additional doses of vaccines to keep them protected. These boosters, given between ages 4 and 6, are doses of the vaccines they received earlier in life to help them maintain the best protection against vaccine-preventable diseases.

Figure 7.11: Vaccines.²⁸⁶

Many states require children to be fully vaccinated (unless they have a medical reason to be exempt) before they can enroll in licensed child care or public school. If vaccinations were missed, a health care provider can help the child’s caregivers to create a catch up schedule to ensure the child correctly “catches up” with the recommended childhood vaccination schedule.²⁸⁷

7.9.4.2 Handwashing

Handwashing is one of the best ways to prevent the spread of illness. It’s important for children (and adults) to wash their hands often, especially when they are likely to get and spread germs, including:

• Before, during, and after preparing food.

• Before eating food.

• After blowing nose, coughing, or sneezing.

• After using the toilet.

• After touching an animal, animal feed, or animal waste.

• After touching garbage.

It’s important for children to learn how to properly wash their hands. When washing hands children (and adults) should follow these five steps every time.

1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.

3. Scrub your hands for at least 20 seconds. Need a timer? Hum or sing the Happy Birthday song or ABCs from beginning to end twice.

4. Rinse your hands well under clean, running water.

5. Dry your hands using a clean towel or air dry them.²⁸⁸

Figure 7.12: A mother helping her son wash his hands.²⁸⁹

Caregivers can help keep children healthy by:

• Teaching them good handwashing techniques.

• Reminding their kids to wash their hands.

• Washing their own hands with the children.²⁹⁰

---

279. Prevalence of Childhood Obesity in the United States by the CDC is in the public domain↩︎

280. Image by Melissa Gutierrez is licensed under CC-BY-2.0↩︎

281. Childhood Obesity Causes & Consequences by the CDC is in the public domain↩︎

282. Food Allergies in Schools by the CDC is in the public domain↩︎

283. Children’s Oral Health by the CDC is in the public domain↩︎

284. Content by Jennifer Paris is licensed under CC BY 4.0↩︎

285. Image by Keesler Air Force Base is in the public domain↩︎

286. Image by Ramstein Air Base is in the public domain↩︎

287. Vaccines for Your Children: Protect Your Child at Every Age by the CDC is in the public domain↩︎

288. Wash Your Hands by the CDC is in the public domain↩︎

289. Image is in the public domain↩︎

290. Handwashing: A Family Activity by the CDC is in the public domain↩︎